The purpose of this project is to demonstrate that a community- based Home Care program of coordinated health, social and other support services, drawing on the same sources of funds now being used to pay for institutionalization (Medicaid), can provide a more desirable, more efficient and less costly option for the care of numbers of elderly and disabled adults currently being inappropriately placed into nursing homes and other institutional settings. It is expected that a significant proportion of elderly and disabled adults who need support services would prefer to receive these in their own homes rather than be placed in a nursing home or other institution. It is expected that the Home Care model of coordinated maintenance services can appropriately maintain at home a significant proportion of elderly and disabled adults who are bound for nursing home or other institutional placement. It is expected that Medicaid payments for this population, if redirected to support Home Care programs can be reduced. The research design allows for the random assignment of potential Home Care recipients into two treatment categories: (1) those who are offered Home Care paid for with Medicaid funds, and (2) those who are offered Home Care paid for by whatever funds are available from the usual sources. Data will be collected on all individuals in both categories. These data will include periodic evaluations of the individual's physical health, psycho-social functioning and quarterly costs of care. Information will be obtained on clients who enter nursing homes and other institutions subsequent to initial contact, on those who are maintained at home with support services, and on those who enter the Home Care service system after a period of residence in a nursing home or other long-term care facility.